| NPI | 1417334525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: DC MD048284) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MD D0089750) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2023-06-20 |